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Rapid response to:


India is urged to make stents essential medicines to help control price

BMJ 2015; 350 doi: (Published 03 June 2015) Cite this as: BMJ 2015;350:h3015

Rapid Response:

Perhaps its time the world looks beyond the use of stents and other invasive techniques for managing coronary artery blockages for the poor who are unable to bear the costs.

Dear Editor,

Coronary stents as well as the procedure is very costly. Not everyone can afford it. For those who can't afford such costly stents and the procedure, we had proposed a look at our nascent technique, which had come about accidentally when we were faced with such grim situations of having to see a patient suffer from a coronary block at far flung areas where it would become difficult or impossible to evacuate a patient with heart attack to a specialized hospital for better care and management. Such incidences were rare though, but then whenever such an occasion arose, it became really desperate and challenging. In those particular instances, as a last resort, when we had already tried all the available options and treatment modalities at the remote and peripheral clinic, this technique was applied. We never could really say the technique worked, as we never could show any proof. Now when we had a proof, we did present it before a huge audience of doctors during the WONCA conference last year.

This technique, which bears the name of our poor, remote and under-developed village "Betaa Kaa Naglaa Technique", or simply the "BKN Technique", can clear off the blocks easily, without having to use stents or bypass surgery. In fact we recently managed a patient whose LEVF had continued to be just around 30% ever since coronary bypass surgery for all the three coronary arteries that was done at one of the best centres of India some 02 years ago. There were many akinetic patches as well, and a trace MR and TR as well. With our technique, there has been a sudden and sharp improvement in the function and performance. Now this same patient, for whom it had been difficult to perform the daily chores, is able to run for nearly a minute on an inclined plane over a treadmill, and with the heart rate returning back to normal within two minutes.

Obviously our technique needs refinement and more research, which we are unable to do from our own resources anymore, and without any administrative or technical help from anyone or from the government. We believe that our "BKN Technique" can be developed by the global medical fraternity, by pooling of resources, as an alternative for the poor who are unable to bear the costly expenses of the present modalities of management.

Best regards.

Competing interests: Our non-invasive "BKN Technique", that can be used as an alternative method for coronary and carotid clot bursting during emergencies, in dire circumstances and when no other option or alternative is available, was presented to the world for the first time on 17 August 2014 at the WONCA's international conference, which was co-hosted by IMA CGP and the IAFP. Later on, this technique was also included by us as a separate chapter in our book, "Innovative Medical Techniques Showcased at International Conferences", which was published on 17 Oct 2014 and was written on invitation received from an international publisher.

08 June 2015
Dr (Lieutenant Colonel) Rajesh Chauhan
Consultant Family Medicine
Dr. Ajay Kumar Singh Parihar; Dr. Shruti Chauhan
Family Healthcare Centre Agra, INDIA.
Family Healthcare Centre, Sector 6 -B (HIG) / 154, Facing Central Park, Avas Vikas Colony Sikandra, AGRA -282007. INDIA.